Independence at Home Act

Health-care reform is in the headlines on a daily basis and, while the ultimate outcome is unknown, it seems certain that changes to the current system are inevitable. An important piece of legistation has recently been reintroduced in Congress. The Independence at Home Act (S 1131, HR 2560) has important implications for health-care providers involved in caring for patients who are chronically ill, particularly providers involved in home care. The Independence at Home (IAH) Act targets the 10% of Medicare beneficiaries that consume more than 60% of Medicaire costs and have poor outcomes.

The IAH Act uses physician- and nurse practioner-directed home calls in an effort to reduce health-care costs and improve outcomes. The IAH Act proposes a 3-year pilot program in the 13 states where Medicare expenditures for the chronically ill are highest and in 13 other states identified as having the greatest needs. The IAH Act proposes to use long-standing, successful home call programs.

Unique features of the IAH Act are that it is paid for by the money it saves through coordinating the care of this high risk population. Providers in the program are held accountable to provide at least 5% savings to Medicare, improve outcomes, and improve patient satisfaction.

The IAH Act is receiving broad bipartisan support. Further details of the legislation can be obtained from the American Academy of Home Care Physicians Web site.